While many forms of skin cancer can be treated, there are advanced stages and aggressive diagnoses that may lead to poor prognosis or outcome. Although no one wants to discuss the potential of a hard-fought battle coming to an end, it can be incredibly beneficial to an individual with late-stage skin cancer, as well as their family and friends, to have these discussions to help make decisions that reflect the patient's wishes. When talking about the potential end of life, there are several things to consider and discuss.
End-of-life planning
End-of-life planning can come in various forms. From discussing where a loved one wants to spend their final days to goals of care, there are many possibilities. Other aspects of end-of-life planning can include whether or not an individual wants palliative or hospice care, the kinds of treatments or resuscitation measures they’d prefer happen, financial planning, and legal decisions. You or a loved one may also want to participate in the funeral or memorial service planning, and other aspects of shaping a legacy.
Advance directives can be created and signed by someone planning end-of-life care. This is a legally binding document, also called a living will, that provides written instructions for care when someone is too sick or physically unable to make decisions on their own. Some aspects of this may include what kinds of machines or resuscitation measures an individual wants to potentially help prolong their life, including feeding tubes, other life supportive measures, or even the possibility of organ donation at end of life. A power of attorney can also be established, to appoint another individual as a health care proxy if need be.1
Hospice care
In addition to documentation and other administrative aspects of end-of-life care, an important decision to be made is whether or not to utilize hospice. Hospice aims to improve the quality of life for an individual coping with late-stage cancer or other life-limiting illness or injury, rather than focusing on aggressive treatment methods with undesirable side effects.
Advance directives
Hospice care provides individuals the right to die with dignity and with less pain.2,3 It utilizes a team approach, enlisting the help of doctors, nurses, occupational therapists, physical therapists, home health aides, counselors, spiritual workers, and trained volunteers. These individuals work together to provide emotional support, spiritual support, pain management, and support services to an individual affected, and their family members.
Hospice care is often used when cancer treatments can no longer control and manage the cancer, but does not mean that an individual or their family is giving up. Hospice is not meant to change the speed of cancer progression and isn’t trying to halt it either. Rather, it provides a method to exercise new priorities that may be more important when there is limited time left.
What studies have shown
Studies have indicated that for some types of cancer, survival rates can be extended, if not kept relatively the same when comparing hospice care to non-hospice care patient counterparts. This could mean that individuals with late-stage cancer are surviving just as long, if not longer, and are in a setting of their choosing and are under the care they want the most.
Additionally, some data has indicated that family members of an individual participating in hospice care are less likely to experience persistent major depression once the individual has passed. This is theorized to be due to the family counseling services hospice provides, that leave family members more emotionally prepared to face the end of their loved one’s life.4,5,6
Hospice care coverage
Hospice care is also available 7 days a week, with a healthcare team member on call 24 hours a day. It’s also generally covered by most insurance plans, Medicare, and Medicaid when a statement from a doctor is obtained stating that the individual has 6 months or less to live if the cancer continues to progress as anticipated.